Physical Activity Patterns, Circadian Rhythms, and Aggressive and Suicidal Behavior among a Larger Sample of the General Population Aged 15 to 34 Years.

BACKGROUND: From a psychological perspective, aggressive behavior, non-suicidal self-injury and suicidal behavior could be considered dysfunctional coping strategies. Poor sleep patterns may further increase such dysfunctional coping. In contrast, regular physical activity may have the power to counteract such dysfunctional coping. Given this background, the aim of the present study was to combine categories of circadian rhythms as a proxy of normative sleep patterns and categories of physical activity patterns, and to associate these categories with aggressive behavior, non-suicidal self-injury and suicidal behavior among a larger sample of adolescents and young adults, aged 15 to 34 years. METHOD: A total of 2991 (55.6% females) individuals aged 15 to 34 years of the so-called Ravansar non-communicable disease cohort study (RaNCD) took part in this study. Participants completed self-rating questionnaires covering circadian-related sleep patterns, regular physical activity, socio-demographic information and dimensions of aggression, non-suicidal self-injury and suicidal behavior. RESULTS: In a first step, both sleep patterns (circadian rhythm disorder: yes vs. no) and physical activity patterns (high vs. low) were dichotomized. Next, participants were assigned to one of four prototypical clusters: No circadian sleep disorders and high physical activity ("Hi-Sleep-Hi-PA"); no circadian sleep disorders and low physical activity ("Hi-Sleep-Lo-PA"); circadian sleep disorders and high physical activity ("Lo-Sleep-Hi-PA"); circadian sleep disorders and low physical activity ("Lo-Sleep-Lo-PA"). Projecting these four clusters on dimensions of aggressive behavior, non-suicidal self-injury and suicidal behavior, the following findings were observed: Participants of the "Hi-Sleep-Hi-PA" reported the lowest scores for aggressive behavior, self-injury and suicidal behavior, compared to participants of the "Lo-Sleep-Lo-PA" cluster. No differences for aggressive behavior, self-injury and suicidal behavior were observed among participants of the "Hi-Sleep-Lo-PA" and the "Lo-Sleep-Hi-PA" clusters. CONCLUSIONS: It appeared that the combination of favorable circadian sleep patterns and high physical activity patterns was associated with lower aggressive behavior, lower self-injury and suicidal behavior as proxies of favorable psychological functioning. In contrast, persons reporting high circadian sleep disorders and low physical activity patterns appeared to demand particular attention and counseling for both their lifestyle issues (sleep and physical activity) and their dysfunctional coping strategies.

Socioeconomic inequalities in prevalence, awareness, treatment and control of hypertension: evidence from the PERSIAN cohort study.

BACKGROUND: Elevated blood pressure is associated with cardiovascular disease, stroke and chronic kidney disease. In this study, we examined the socioeconomic inequality and its related factors in prevalence, Awareness, Treatment and Control (ATC) of hypertension (HTN) in Iran. METHOD: The study used data from the recruitment phase of The Prospective Epidemiological Research Studies in IrAN (PERSIAN). A sample of 162,842 adults aged > = 35 years was analyzed. HTN was defined according to the Joint National Committee)JNC-7(. socioeconomic inequality was measured using concentration index (Cn) and curve. RESULTS: The mean age of participants was 49.38(SD = ± 9.14) years and 44.74% of the them were men. The prevalence of HTN in the total population was 22.3%(95% CI: 20.6%; 24.1%), and 18.8%(95% CI: 16.8%; 20.9%) and 25.2%(95% CI: 24.2%; 27.7%) in men and women, respectively. The percentage of awareness treatment and control among individuals with HTN were 77.5%(95% CI: 73.3%; 81.8%), 82.2%(95% CI: 70.2%; 81.6%) and 75.9%(95% CI: 70.2%; 81.6%), respectively. The Cn for prevalence of HTN was -0.084. Two factors, age (58.46%) and wealth (32.40%), contributed most to the socioeconomic inequality in the prevalence of HTN. CONCLUSION: The prevalence of HTN was higher among low-SES individuals, who also showed higher levels of awareness. However, treatment and control of HTN were more concentrated among those who had higher levels of SES, indicating that people at a higher risk of adverse event related to HTN (the low SES individuals) are not benefiting from the advantage of treatment and control of HTN. Such a gap between diagnosis (prevalence) and control (treatment and control) of HTN needs to be addressed by public health policymakers.

Epidemiology of Gastric Cancer in North Africa and the Middle East from 1990 to 2017.

INTRODUCTION: Gastric cancer is the fifth most common cancer worldwide and the third cause of cancer deaths and disability-adjusted life years (DALYs) worldwide. The countries of the Middle East and North Africa are similar in many determinants of health, but there are significant differences in the incidence of gastric cancer in these countries. Therefore, the purpose of this study was to compare the burden of gastric cancer in MENA countries with appropriate policies to reduce the incidence and mortality of gastric cancer in the region. MATERIALS AND METHODS: GBD database data were used to assess the gastric cancer indices in MENA countries consisted of 21 countries in the Middle East and North Africa in 1900 and 2017. Gastric cancer-related analysis using DALY counts, which is the sum of YLLs (total years lost due to premature death) and YLDs (years lost due to disability), and incidence rates, prevalence rates, death rates, and standardized age rates (ASR) were measured. RESULTS: The incidence of gastric cancer has decreased in the world and the MENA region from 1990 to 2017, which is higher than the global average in MENA. But death rates in the region have decreased below the global average. The trend of changes in DALY count has increased from 1990 to 2017 in all countries in the region except Turkey. This increase is higher in men than in women and also in Iran. In these countries, the highest percentage of total DALY of gastric cancer is attributable to the risk factors for high sodium and cigarette consumption, in Turkey and the United Arab Emirates, respectively (from 1990 to 2017) Also, the largest decrease is in the UAE and Iraq, respectively. CONCLUSION: Despite a decrease in the incidence of gastric cancer and, possibly, due to late diagnosis and poor health services, the attenuation of gastric cancer is high in MENA countries. Therefore, it is recommended to reduce the attenuation of screening programs before 50 years old for early detection in addition to prevention programs and to reduce smoking, especially in men.

Prevalence of metabolic syndrome using international diabetes federation, National Cholesterol Education Panel- Adult Treatment Panel III and Iranian criteria: results of Tabari cohort study.

BACKGROUND: Metabolic syndrome is defined by co-incidence of multiple metabolic disorders such as central obesity, high triglycerides, low HDL, hyperglycemia and high blood pressure, which increases the risk of cardiovascular disease and diabetes. The aim of this study was to estimate the prevalence of metabolic syndrome using Adult Treatment Panel III (ATP-III), International Diabetes Federation (IDF) and Iranian criteria in large-scaled population based cohort study and to determine the concordance between these criteria. METHODS: In the present study all information collected in Tabari cohort study(TCS) were utilized. These information were collected using a structural questionnaire and taking blood samples from all the participants. Blood pressure and anthropometric indices were measured for all participants by trained practitioners. Categorical variables were compared using chi-square test. In addition, the quantitative variables were compared between the two the groups using independent t-test. Kappa coefficient was estimated to show the agreement between the results of the three criteria. RESULTS: The prevalences of Metabolic syndrome were 41.10%(CI 95%:40.10-42.02), 44.60%(CI 95%:43.61-45.54), and 30.80% (CI 95%:29.89-31.69) based on ATPIII, international IDF and IDF Iranian criteria respectively. The Kappa agreement coefficients between Iranian IDF with ATPIII definition and international IDF were estimated as 61.80% and 71.20% in the total population respectively. CONCLUSION: Kappa coefficient showed that the Iranian IDF had a good agreement with International IDF and an intermediate agreement with the ATP-III. Considering more emphasis of international and Iranian IDF on waist circumference (WC), a better agreement between these two criteria is plausible. Regarding the high prevalence of abdominal obesity among Iranian population, applying these criteria to identify high risk persons might be helpful.

Age of Natural Menopause and Related Factors among the Tabari Cohort.

OBJECTIVES: The age of menopause is affected by several factors. In this study we aimed to identify the age of natural menopause and its related factors in a large-scale population-based cohort in Iran. METHODS: In this study, a subset of data collected during the enrollment phase of the Tabari cohort study was utilized. Reproductive history and other related data were collected using a structured questionnaire. Blood samples were obtained from all participants. Data were analyzed using chi-square test, independent t test, and ANOVA as well as a multivariate linear regression model. RESULTS: Among participants of the Tabari cohort, 2,753 were menopausal women. The mean age of natural and induced menopause was 49.2 ± 4.7 and 43.2 ± 6.4 years, respectively (P = 0.001). The number of pregnancies, duration of breastfeeding, level of education, residency, presence of thyroid disease, and body mass index affected the age of menopause. After adjustments for confounding variables, the number of pregnancies remained significantly associated with late menopause. CONCLUSIONS: The age of natural menopause in this study was similar to that in other studies, and the number of pregnancies was positively associated with the age of menopause after adjustments for confounding variables.

Viral infections and risk of thyroid cancer: A systematic review and empirical bayesian meta-analysis.

OBJECTIVE: The associations between viruses and the cancer have been conducted in several studies while there has been no systematic review and meta-analysis about the association between viral infections and thyroid cancer (TC). Therefore, we investigated the association between viral infection and TC risk. METHODS: Systematic search was done from 1994 to 2019 in Web of sciences (ISI), PubMed, and Scopus databases. Pooled logarithm of odds ratio (OR) and their corresponding 95 % confidence interval (CI) and pooled prevalence of viral infections were calculated to find the association between the viral infections and TC risk and overall prevalence of the viral infections in TC. RESULTS: Twenty-three of 852 original articles were selected and included in the study. According to the results of the random effect meta-analysis, the pooled prevalence of viral infections in the TC patients was 37 % (95 % C. I = 22 %-55 %). In addition, there was a significant association between viral infections (log (OR) = 1.51, 95 % credible interval = 0.68-2.39) and TC risk. The highest associations were observed between TC risk and Simian Vacuolating Virus 40 (SV40) and B19 infections, respectively. The lowest non-significant association was found between TC risk and Poliovirus type 1 infection. The significantly heterogeneity was observed between included studies (Q test: p-value<0.001; I2 = 73.82 %; τ2 = 1.08, 95 % Cr. I = 0.47-1.94). CONCLUSIONS: Results clearly demonstrated the potential pathogenetic association between viral infections and increased risk of TC.

Prevalence of depression and related social and physical factors amongst the Iranian elderly population in 2012.

AIM: Depression is the most common psychiatric disorder and the second most common cause of disability among older adults. The objective of the present study was to investigate the prevalence of depression and related social and physical factors in the Iranian elderly population in 2012. METHODS: In this cross-sectional study, 1350 Iranian older adults aged older than 60 years were selected considering the gender proportion of the population of five out of 31 provinces of Iran. To define depression, the short form (15-item) of the Geriatric Depression Scale was administered. To analyze the data, logistic regression was carried out using stata software (version 12.0). RESULTS: From 1350 participants, 642 (47.5%) were men and the rest were women. The mean ± SD age of the sample was 69 ± 7 years. The prevalence of depression was 36.7% (42.5% in women and 30.2% in men). At the bivariate level, sex, educational level, marital status, satisfaction with income, occupation, relationship with the financial provider, leisure time, activities of daily living, and frequency of meeting with friends and relatives were factors determining the odds of depression. However, after multivariate control, marital status and educational level were removed from the final model. In contrast, smoking, which was insignificant at the bivariate level, became significant at the multivariate level. CONCLUSIONS: Depression has a high prevalence among the Iranian elderly population. Therefore, it is important that this vulnerable group is provided with access to supportive environments that involve active participation in occupational and social activities, which in turn help reduce the chance of suffering from depression. Geriatr Gerontol Int 2017; 17: 126-131.